APPENDIX A. APPENDIX TO CHAPTER 29A-3

The Supreme Court of South Dakota by order dated March 17, 1997, adopted the following rule:

State of South Dakota ) In Circuit CourtCounty of ________ ) ss ______________ Judicial Circuit)

Estate of )____________________ ) FILE NO.____________Deceased )

STATEMENT OF CLAIM

This claim is made against the estate:

Description of Claim Due Date, If Not Yet Due Amount1._______________________ ____________________ $__________2._______________________ ____________________ $__________3._______________________ ____________________ $__________4._______________________ ____________________ $__________5._______________________ ____________________ $__________TOTAL CLAIM $__________* This claim is unsecured.

* This claim is secured by __________.

* This claim is contingent or unliquidated because __________.

__________.

Dated _______.

__________

Claimant's Signature

__________

Claimant's Name

__________

Claimant's Address

__________

Claimant's Telephone Number (The following information shall appear on the back of the Statement of Claim form)

The Statement of Claim is presented by:1. Filing the Statement of Claim with the clerk of courts and mailing a copy to the personal representative, or2. Mailing or delivering the Statement of Claim to the personal representative. (A proof of notice should be filed with the clerk if the Statement of Claim is mailed to the personal representative.)

If the claim is not yet due, the date when it will become due must be stated. If the claim is secured, the security must be described. If the claim is contingent or unliquidated, the nature of the uncertainty must be stated. See SDCL 29A-3-804.Comments:

No presentation of claim is required in regard to matters claimed in court proceedings brought against the decedent which were pending in any court at the time of death. See SDCL 29A-3-804(b). A claim can be "presented" by commencing an action against the personal representative within the time for presenting a claim. See SDCL 29A-3-804(a)(2).

The time limitations specified in SDCL 29A-3-803 do not apply to liability claims against the decedent or the personal representative to the extent that they are "protected by liability insurance," or any proceeding to enforce any mortgage, pledge, or other lien upon property of the estate.

Source: SL 1997, ch 348 (Supreme Court Rule 97-43).